Naorungroj Thummaporn, Baldwin Ian, Eastwood Glenn, Bellomo Rinaldo
Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Division of Intensive Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Int J Artif Organs. 2023 Apr;46(4):209-214. doi: 10.1177/03913988231155253. Epub 2023 Mar 9.
In patients with liver failure, continuous renal replacement therapy (CRRT) without anticoagulation may be necessary. A new heparin coated membrane (oXiris) may prolong circuit life in this setting.
In liver failure patients not receiving anticoagulation, to compare CRRT circuit life with the oXiris versus the AN69 ST100 (usual care) membrane.
Randomized single cross-over trial.
We studied 20 patients and 39 circuits. Twenty-five treatments used femoral and 14 internal jugular access catheters. Median circuit life was 21 h (IQR: 8.25-35.5) with the AN69 versus 16.0 h (14-25) with the oXiris membrane ( = 0.36). Median first circuit duration was 14 (11.25-23) h for the AN69 ST100 versus 16 (8 -26) for the oXiris membrane. There was also no difference between the AN69 ST100 or oXiris membrane circuits using femoral access at 13 (8 -22.5) versus 15.5 (12.5-21.5) h ( = 0.57) or internal jugular access at 28 (13-47) versus 23 (21-29) h ( = 0.79), respectively.
The oXiris heparin-grafted membrane does not appear to prolong circuit life in liver failure patients receiving CRRT without anticoagulation.
对于肝功能衰竭患者，可能需要进行无抗凝的连续性肾脏替代治疗（CRRT）。一种新型肝素涂层膜（oXiris）可能会延长这种情况下的体外循环使用寿命。
在未接受抗凝治疗的肝功能衰竭患者中，比较使用oXiris膜与AN69 ST100膜（常规治疗）进行CRRT时的体外循环使用寿命。
随机单交叉试验。
我们研究了20例患者和39个体外循环。25次治疗使用股静脉置管，14次使用颈内静脉置管。使用AN69膜时，体外循环的中位使用寿命为21小时（四分位间距：8.25 - 35.5），而使用oXiris膜时为16.0小时（14 - 25）（P = 0.36）。AN69 ST100膜的首次体外循环中位持续时间为14（11.25 - 23）小时，oXiris膜为16（8 - 26）小时。使用股静脉置管时，AN69 ST100膜与oXiris膜的体外循环时间也无差异，分别为13（8 - 22.5）小时和15.5（12.5 - 21.5）小时（P = 0.57）；使用颈内静脉置管时，分别为28（13 - 47）小时和23（21 - 29）小时（P = 0.79）。
对于接受无抗凝CRRT的肝功能衰竭患者，oXiris肝素化膜似乎并不能延长体外循环使用寿命。
